Does Medicare Cover Therapy?

There are various types of therapy. But all in all, every treatment out there is meant to help treat a person’s illness or condition, whether it is a physical ailment or a mental health issue.

So a common question many people have is, “Does Medicare cover Therapy?” In this article, we answer the question in clear, plain English. You will also find the average costs of various types of therapy and other helpful info.

The short answer is yes; Medicare will cover the cost of various types of therapy. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your therapy. Below we look at what these are so you know what to expect.

Original Medicare (Medicare Part A and Part B) provides coverage for the costs of many types of therapy, including mental health therapy and physical therapy. Upon enrolling in Medicare, you will receive a Welcome to Medicare preventive visit. During this visit, one of the things the doctor will do is review your risks for depression.

Mental Health Therapy

Medicare Part A provides coverage for mental health services if the person is admitted as an inpatient to a general or psychiatric hospital. Medicare Part B covers one depression screening per year. Part B also covers single or group therapy by state-licensed experts.

Medicare Advantage plans (Medicare Part C) also provide coverage for mental health therapy. They cover everything Original Medicare covers and some additional benefits. However, out-of-pocket costs will vary depending on the plan provided by the plan providers.

Medicare Part D provides coverage for prescription drugs to treat mental health issues.

Physical Therapy

Medicare also provides coverage for physical therapy, but only when it is medically necessary. Part A may cover inpatient rehabilitation and physical therapy services when they are medically necessary to improve your condition after hospitalization.

Medicare Part B covers physical therapy as long as it is medically necessary. Coverage for physical therapy may also include diagnosis and treatment of your condition that affect your ability to function.

Medicare Advantage plans (Medicare Part C) also provide coverage for physical therapy. They cover everything Original Medicare covers as well as some additional benefits. However, out-of-pocket costs will vary depending on the specifics of your plan.

Medicare Part D may cover prescription drugs that you may need after physical therapy.

Medical Nutrition Therapy

Medicare also provides coverage for medical nutrition therapy (MNT). But only under certain conditions such as if you have diabetes or kidney disease. MNT for obesity is also covered by Medicare under certain conditions, including having a body mass index (BMI) of 30 or more.

How Much Does Therapy Cost?

The average mental health counseling can cost between $60 to $120 per session. But it can also go as high as $250 or more.

Physical therapy can cost $20 to $55 per session. The typical rates of a dietician range between $70 to $150.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.